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WRIST PHYSEAL (growth plate) FRACTURES

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  • ​Peak age for injury pre adolescent growth spurt

  • Salter-Harris II most common

  • Distal radial physeal fractures uncommon in children under 5 years

 

MECHANISM: FOOSH

 

MANAGEMENT​

  • Analgesia

  • ​Angulation >20 degrees requires reduction, more angulation is accepted in children <8 years and those presenting late.

  • Less angulation accepted in patients with less than 2 years of growth remaining.

  • If delayed presentation >5 days closed reduction risks growth plate damage and is not advised.

  • Post reduction X-ray

  • Below Elbow backslab

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CLASSIFICATION

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REFER ORTHO IF:​​

  • Neurovascular injury

  • Open fracture

  • Salter Harris III and IV

  • Reduction not successful or possible.

  • Associated fracture in same limb.

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